Individual provider Active NPI

Jessica Colleen Wesley, CPNP

  • Pediatric Nurse Practitioner
  • Cedar Park, TX
National Provider Identifier
1306220181
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP123965 Issued in TX
Practice address
1464 E Whitestone Blvd Ste 2104
Cedar Park, TX 78613-9079
Phone
(512) 260-8100
NPI assigned
Jul 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP123965 TX Primary

Addresses

Primary practice location

1464 E Whitestone Blvd Ste 2104
Cedar Park, TX 78613-9079

Mailing address

1464 E Whitestone Blvd Ste 2104
Cedar Park, TX 78613-9079
Phone (512) 260-8100

Other practice location 1

12661 W Hwy 29
Liberty Hill, TX 78642
Phone (512) 778-5111

Other identifiers 1

IdentifierTypeStateIssuer
361998301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP123965TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michael C. Holmes, MD, PLLC PastSince Feb 19, 2023 Accepting new patients
Grow Pediatrics and Adolescent Medicine PLLC Past Accepting new patients
Whitestone Pediatrics Incorporated PastSince Feb 19, 2023 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1306220181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1464 E WHITESTONE BLVD STE 2104",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786139079",
            "telephone_number": "512-260-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1464 E WHITESTONE BLVD STE 2104",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786139079",
            "telephone_number": "512-260-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12661 W Hwy 29",
            "address_purpose": "LOCATION",
            "city": "Liberty Hill",
            "state": "TX",
            "postal_code": "78642",
            "country_code": "US",
            "telephone_number": "512-778-5111",
            "fax_number": "512-260-8103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESLEY",
        "first_name": "JESSICA",
        "middle_name": "COLLEEN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-12",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP123965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361998301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.